﻿<%@ Page Title="" Language="C#" MasterPageFile="~/personal-accident/proposalforms/PersonalAccidentProposalMasterPage.master" Async="true"
    AutoEventWireup="true" CodeFile="hsbc_proposal_form.aspx.cs" Inherits="personal_accident_hsbc_proposal_form" %>

<%@ Register Src="~/controls/usrNoJS.ascx" TagName="usrNoJS" TagPrefix="ucNoJS" %>
<%@ Register Src="~/controls/usrPhoneNo.ascx" TagName="usrPhoneNo" TagPrefix="uc1" %>
<%@ Register Src="~/controls/usrDate.ascx" TagName="usrDate" TagPrefix="uc2" %>
<%@ Register Src="~/controls/usrIdNumber.ascx" TagName="usrIdNumber" TagPrefix="uc3" %>
<%@ Register Src="~/controls/usrNationality.ascx" TagName="usrNationality" TagPrefix="uc4" %>
<%@ Register Src="~/controls/usrSalutation.ascx" TagName="usrSalutation" TagPrefix="uc5" %>
<%@ Register Src="~/controls/usrMaritalStatus.ascx" TagName="usrMaritalStatus" TagPrefix="uc6" %>
<%@ Register Src="~/controls/usrGender.ascx" TagName="usrGender" TagPrefix="uc7" %>
<asp:Content ID="Content1" ContentPlaceHolderID="ContentPlaceHolder1" runat="Server">
 
    <asp:ScriptManager ID="ScriptManager1" runat="server"></asp:ScriptManager>
    
    <div id="container">
    
        <div id="nav_top">
            <div class="left pad_8yr">
                <a href="/personal-accident/results.aspx" onclick="return confirm('Are you sure to go back?');">
                    <img src="/images/forms_proposal/button/back.png" alt="Back" /></a></div>
            <div class="right pad_8yr">
                <img src="/images/forms_proposal/nav/logo_comparexpress.png" alt="CompareXpress" /></div>
        </div>
        
        <ucNoJS:usrNoJS ID="usrNoJS1" runat="server" />
        
        <!-- #Include file="../../includes/body_loader.inc" -->
        

        <script type="text/javascript">
            IncreaseProgress(5);
        </script>
        
        <div id="divContent" style="display: none">
            <div id="contentBody">
                <div id="header">
                    <div class="seperator"></div>
                    <div class="right" style="width: 240px">
                        <div class="quotesum_button">
                            <img src="/images/forms_proposal/button/quotesum.png" width="240" height="73" alt="Quote Summary" /></div>
                    </div>
                    <h1>Online Personal Accident Proposal Form - <asp:Label ID="lblProvider" runat="server"></asp:Label></h1>
                    <div class="seperator"></div>
                    <div class="quotesum">
                        <div class="top"></div>
                        <div id="divQuoteSummery" class="body pad_15x">
                            <!-- QUOTE SUMMARY | Start -->
                            <div class="w21per left pad_25xr">
                                <h1><asp:Label ID="lblPlanHead" runat="server" Text="Plan Name : " ></asp:Label></h1>
                                <p><asp:Label ID="lblPlanName" runat="server"></asp:Label></p>
                            </div>
                            <div class="w21per left pad_25xr">
                                <h1><asp:Label ID="lblPolicyHead" runat="server" Text="Policy Type : "></asp:Label></h1>
                                <p><asp:Label ID="lblPolicyType" runat="server"></asp:Label></p>
                            </div>
                            <div class="w21per left pad_25xr">
                                <h1><asp:Label ID="lblPremiumHead" runat="server" Text="Annual Premium  : $"></asp:Label></h1>
                                <p><asp:Label ID="lblAnnualPremium" runat="server"></asp:Label> (+ GST 7%)</p>
                            </div>
                            <!-- QUOTE SUMMARY | End   -->
                        </div>
                        <div class="bottom"></div>
                    </div>
                </div>
                <div class="seperator"></div>
                <div id="body"></div>
                <div id="divValidationSummary">
                    <asp:ValidationSummary ID="vsproposal" runat="server" CssClass="errorSummary" ValidationGroup="proposal"
                        HeaderText="Oops please complete the form" />
                </div>
                <div style="display: none">
                    <asp:TextBox ID="txtPolicyType" runat="server"></asp:TextBox>
                    <asp:Label ID="lblCompanyId" runat="server"></asp:Label>
                </div>
                <div class="form">
                    <div class="top">
                        <div class="left">
                            <div class="pad_10t pad_35xl white">Online Personal Accident Proposal Form</div>
                        </div>
                        <div class="right"></div>
                    </div>
                    <div class="body">
                        <div class="inner">
                            <div class="pad_20x10y">
                                <div class="hilite">
                                    <div class="top"></div>
                                    <div class="body_in pad_15x">
                                        <h1>Main Applicant</h1>
                                        <div class="seperator"></div>
                                        <div class="w43per left">
                                            <div id="divASalutation">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Salutation:</div>
                                                <div class="left">
                                                    <uc5:usrSalutation ID="ddlSalutation" runat="server" ValidationGroup="proposal" />
                                                </div>                                                
                                            </div>
                                            <div style="display: none">
                                                <asp:TextBox ID="txtSalGenderValid" Text="Valid" runat="server"></asp:TextBox>
                                                <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtSalGenderValid"
                                                    ValidationGroup="proposal" ID="csvSalGender" ClientValidationFunction="CheckSalGenderValid"
                                                    OnServerValidate="CheckSalGenderValid" runat="server" ErrorMessage="Salutation and gender do not match."
                                                    Text=""></asp:CustomValidator>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divName">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Name (as shown in NRIC / Passport):</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtName" MaxLength="50" runat="server" size="25"></asp:TextBox>&nbsp;
                                                    <asp:RequiredFieldValidator ID="rfvName" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtName"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revName" runat="server" ControlToValidate="txtName"
                                                        ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Gender:</div>
                                                <div class="left">
                                                    <uc7:usrGender ID="ddlGender" ValidationGroup="proposal" IsEnabled="true" ErrorMessage="" runat="server" />
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Marital Status:</div>
                                                <div class="left">
                                                    <uc6:usrMaritalStatus ID="ddlMaritalStatus" runat="server" IsEnabled="true" ValidationGroup="proposal" ErrorMessage="" />
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divNRICNo">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> NRIC Number:</div>
                                                <div class="left">
                                                    <uc3:usrIdNumber ID="ddlIdNumber" runat="server" ValidationGroup="proposal" />
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divAEmail">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> E-mail:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtEmail" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvEmail" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtEmail" Display="Dynamic"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revEmail" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtEmail" ValidationExpression="\w+([-+.']\w+)*@\w+([-.]\w+)*\.\w+([-.]\w+)*"></asp:RegularExpressionValidator>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="w56per left">
                                           <%-- <asp:UpdatePanel ID="UpdatePanel1" runat="server">
                                                <ContentTemplate>--%>
                                                    <div id="divPostCode">
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            <span class="red">*</span> Postcode:
                                                        </div>
                                                        <asp:TextBox ID="txtPostCode" size="8" onkeypress="restrictToNumbers(event)" runat="server" MaxLength="6" Width="80px"></asp:TextBox>
                                                       <%-- <asp:ImageButton ID="ibtPostCode" runat="server" CssClass="button" align="absmiddle"
                                                            OnClick="ibtPostCode_Click" Width="108" ValidationGroup="PostCode" AlternateText="Get Address"
                                                            ImageUrl="~/images/forms_proposal/button/getaddress.png" />
                                                        <asp:UpdateProgress runat="server" ID="uplUpProgress" DisplayAfter="500">
                                                            <ProgressTemplate>
                                                                <span style="position: absolute; text-align: right; width: 390px;">
                                                                    <img src="../../images/loading7.gif" id="ldPostCode" alt="loading" />
                                                                </span>
                                                            </ProgressTemplate>
                                                        </asp:UpdateProgress>--%>
                                                        <asp:RequiredFieldValidator ID="rfvPCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="PostCode" ControlToValidate="txtPostCode"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revPCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="PostCode" ValidationExpression="[0-9]{6}"
                                                            ControlToValidate="txtPostCode"></asp:RegularExpressionValidator>
                                                        <asp:RequiredFieldValidator ID="rfvPostCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtPostCode"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revPostCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{6}"
                                                            ControlToValidate="txtPostCode"></asp:RegularExpressionValidator>
                                                    </div>
                                                    <div runat="server" visible="false" id="divAddressList">
                                                        <div class="h10"></div>
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            Please choose your address
                                                        </div>
                                                        <asp:DropDownList ID="ddlAddressList" AutoPostBack="true" Width="320px" runat="server" OnSelectedIndexChanged="ddlAddressList_SelectedIndexChanged">
                                                        </asp:DropDownList>
                                                    </div>
                                               <%-- </ContentTemplate>
                                            </asp:UpdatePanel>--%>
                                            <div class="h10"></div>
                                            <div id="divUnitNo">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Unit Number:
                                                </div>
                                                <asp:TextBox ID="txtUnit1" MaxLength="10" runat="server" size="8"></asp:TextBox>-
                                                <asp:RequiredFieldValidator ID="rfvUnit1" runat="server" CssClass="validationErrorControl"
                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtUnit1"></asp:RequiredFieldValidator>
                                                <asp:TextBox ID="txtUnit2" MaxLength="10" runat="server" size="8"></asp:TextBox>
                                                <asp:RequiredFieldValidator ID="rfvUnit2" runat="server" CssClass="validationErrorControl"
                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtUnit2"></asp:RequiredFieldValidator>
                                            </div>
                                            <div class="h10"></div>
                                            <asp:UpdatePanel ID="UpdatePanel2" runat="server">
                                                <ContentTemplate>
                                                    <div id="divPCAddress">
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            <span class="red">*</span> Address:
                                                        </div>
                                                        <span id="divAddress"></span>
                                                        <asp:TextBox ID="txtAddress" runat="server" TextMode="MultiLine" MaxLength="120"
                                                            Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvAddress" runat="server" CssClass="validationErrorControl"
                                                            ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtAddress"></asp:RequiredFieldValidator>
                                                    </div>
                                                </ContentTemplate>
                                            </asp:UpdatePanel>
                                            <div class="h10"></div>
                                            <div id="divNationality">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Nationality:</div>
                                                <div class="left">
                                                    <uc4:usrNationality ID="ddlNationality" runat="server" ErrorMessage="" ValidationGroup="proposal" />
                                                </div>
                                            </div>
                                        </div>
                                        <div class="clear"></div>
                                        <div class="h10"></div>
                                        <div style="border: 1px solid #ccc; width: 912px; background: #d2d2d2;">
                                            <div class="h10"></div>
                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                Contact Info:</div>
                                            <div id="divMobileNo" class="w190 note left">
                                                <span class="red">*</span> Mobile Number<br />
                                                <uc1:usrPhoneNo ID="txtMobileNo" IsEnabled="true" IsRequired="true" PhoneNoRequireErrorMessage="Require mobile number."
                                                    PhoneNoErrorMessage="Mobile phone number should 8 digits." PhoneNoValidErrorMessage="Invalid mobile phone number."
                                                    runat="server" ValidationGroup="proposal" />
                                            </div>
                                            <div id="divHomePhoneNo" class="w190 note left">
                                                Home Phone Number<br />
                                                <uc1:usrPhoneNo ID="txtHomePhoneNo" runat="server" ValidationGroup="proposal" IsRequired="False" />
                                            </div>
                                            <div id="divOfficePhoneNo" class="w190 note left">
                                                Office Phone Number<br />
                                                <uc1:usrPhoneNo ID="txtOfficePhoneNo" runat="server" ValidationGroup="proposal" IsRequired="False" />
                                            </div>
                                            <div class="h10"></div>
                                        </div>
                                        <div style="display: none"><asp:TextBox ID="txtIsCover" runat="server"></asp:TextBox></div>
                                        <div style="display: none"><asp:TextBox ID="txtCHCount" runat="server"></asp:TextBox></div>
                                    </div>
                                    <div class="bottom"></div>
                                </div>
                                
                                <div class="seperator"></div>
                    
                    

                                <script type="text/javascript">
                                    IncreaseProgress(40);
                                </script>
                        
                                <asp:Panel ID="pnlDetailsOfOtherInsured" runat="server" Width="100%">
                                    <div class="hilite" id="div1">
                                        <div class="top"></div>
                                        <div class="body_in pad_15x">
                                            <h1> Details of other insured persons</h1>
                                            <div class="seperator"></div>
                                            <h3>Spouse</h3>
                                            <div class="h10"></div>                                            
                                            <div class="w43per left">
                                                <div id="divSpouseName">
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Name (as shown in NRIC / Passport):</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtSpouseName" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvSpouseName" runat="server" CssClass="validationErrorControl"
                                                            ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtSpouseName"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revSpouseName" runat="server" ControlToValidate="txtSpouseName"
                                                            ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                            Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div id="divSpouseNRICNo">
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span>NRIC Number:</div>
                                                    <div class="left">
                                                        <uc3:usrIdNumber ID="ddlSpouseIdNumber" runat="server" ValidationGroup="proposal" />
                                                    </div>
                                                </div>
                                                <%--<div style="display: none;">                              
                                                    <div>
                                                        <asp:TextBox ID="txtNRIC" Text="Valid" runat="server"></asp:TextBox>
                                                        <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtNRIC"
                                                            ValidationGroup="proposal" ID="csvNRIC" 
                                                            OnServerValidate="Check2NRICValid" runat="server" ErrorMessage=""
                                                            Text=""></asp:CustomValidator>-
                                                   
                                                    </div>
                                                </div>--%>
                                            </div>
                                            <div class="w56per left">
                                                <div id="divSpouseNationality">
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Nationality:</div>
                                                    <div class="left">
                                                        <uc4:usrNationality ID="ddlSpouseNationality" runat="server" ErrorMessage="" ValidationGroup="proposal" />
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="clear"></div>
                                        </div>
                                        <div class="bottom"></div>
                                    </div>                                    
                                    <div class="seperator"></div>
                                </asp:Panel>

                                <script type="text/javascript">
                                    IncreaseProgress(55);
                                </script>
                                
                                <div class="norm" id="divDeclarationHeader">
                                    <div class="top"></div>
                                    <div class="body" id="divDeclaration">
                                        <div class="pad_15x">
                                            <h1>Declaration </h1>(Tick each box to confirm your eligibility for coverage)
                                            <div class="seperator"></div>
                                            <p>I confirm on behalf of myself/my Spouse that:</p>
                                            <div class="h7"></div>
                                            <div>
                                                <asp:CheckBox onclick="CheckSPRPR()" ID="chkSPRPR" runat="server" Text="" />
                                                <span>I/We are Singapore citizen/s or Singapore Permanent Resident/s.</span> 
                                                <asp:RequiredFieldValidator ControlToValidate="txtSPRPR" ID="rfvSPRPR" runat="server"
                                                    ValidationGroup="proposal" ErrorMessage=""></asp:RequiredFieldValidator>
                                                <div style="display: none">
                                                    <asp:TextBox ID="txtSPRPR" runat="server" />
                                                </div>
                                            </div>
                                            
                                            <div id="divElgibleAge">
                                                <asp:CheckBox onclick="CheckElgibleAge();" ID="chkElgibleAge" runat="server" Text="" />
                                                <span>I/my Spouse (and our children, if Family coverage is chosen) are within the eligible
                                                    age.</span> 
                                                <asp:RequiredFieldValidator ControlToValidate="txtElgibleAge" ID="rfvElgibleAge"
                                                    runat="server" ValidationGroup="proposal" ErrorMessage=""></asp:RequiredFieldValidator>
                                                <div style="display: none">
                                                    <asp:TextBox ID="txtElgibleAge" runat="server" />
                                                </div>
                                            </div>
                                            <div class="h7"></div>
                                            <div id="divNoEngaged">
                                                <asp:RadioButton onclick="ValEngaged();CheckEngagedValidationCss();ShowHideDiv('divPaymentMode',true);"
                                                    ID="rdoNoEngaged" runat="server" GroupName="insurancetransferred" />
                                                <asp:Label ID="lblNoEngaged" runat="server" Text="I/my Spouse am/are not engaged in the following occupations OR"></asp:Label>
                                            </div>
                                            
                                            <div id="divYesEngaged">
                                                <asp:RadioButton onclick="ValEngaged();CheckEngagedValidationCss();ShowHideDiv('divPaymentMode',true);"
                                                    ID="rdoYesEngaged" runat="server" GroupName="insurancetransferred" />
                                                <asp:Label ID="lblYesEngaged" runat="server" Text="I/my Spouse am/are engaged in the following occupations and we would like to apply for restricted coverage.‡"></asp:Label>
                                                <asp:RequiredFieldValidator ControlToValidate="txtEngaged" ID="rfvEngaged" runat="server"
                                                    ValidationGroup="proposal" ErrorMessage=""></asp:RequiredFieldValidator>
                                            </div>
                                            <div class="h7"></div>
                                            <div style="display: none">
                                                <asp:TextBox ID="txtEngaged" runat="server" />
                                            </div>
                                            <div class="h7"></div>
                                            <div class="b_msg">
                                                <ul>
                                                    <li>Industrial workers using heavy machinery; woodworking related or any occupation
                                                        involving aviation activities;</li>
                                                    <li>Armed services personnel; police force personnel, fire fighters;</li>
                                                    <li>Construction/unskilled workers; ship crew or workers on board vessels, stevedores,
                                                        shipbreakers;</li>
                                                    <li>Occupations involving diving, platforms, oil and gas rig and/or offshore work;</li>
                                                    <li>Occupations involving work at heights/underground and/or handling of hazardous chemical/electricity;
                                                        professional sports teams;</li>
                                                    <li>Professional divers and jockeys;</li>
                                                    <li>Welders and the like.</li>
                                                </ul>
                                            </div>
                                            <div class="h7"></div>
                                            <p>‡ Restricted coverage only applies during off-duty hours. In this case,
                                                the Plan will not cover for any injury caused directly or indirectly by the insured’s
                                                occupational activities. </p>
                                        </div>
                                    </div>
                                    <div class="bottom"></div>
                                </div>
                                
                                <div class="seperator"></div>
                                
                                <div class="norm" id="divAuthorisationHeader">
                                    <div class="top"></div>
                                    <div class="body" id="divAuthorisation">
                                        <div class="pad_15x">
                                            <h1>Other Declaration and Authorisation</h1>
                                            <div class="seperator"></div>
                                            In addition to the above:<br /><br />
                                            <p>
                                            (a) I understand that my/our nominated account operator is entitled to (i) Reject
                                            HSBC Insurance (Singapore) Pte. Limited’s debit instructions if my/our account does
                                            not have sufficient funds and charge me/us a fee for this. (ii) At its discretion
                                            allow the debit even if this results in an overdraft on the account and impose charges
                                            accordingly.</p>
                                            <p>
                                                (b) This authorisation will remain in force until my/our written revocation through
                                                HSBC Insurance (Singapore) Pte. Limited.</p>
                                            <p>
                                                (c) I understand that the benefits of the policy will only be payable due to an
                                                accident occuring during the period of coverage.</p>
                                            <div class="seperator"></div>
                                            <p><b>Important Notes:</b></p>
                                            <p>
                                                <i>It is usually disadvantageneous to replace an existing Accident Policy with a new
                                                    one. The disadvantages include, but are not limited to (i) Receiving a lower level
                                                    of benefits at a higher or same cost, or (ii) Suffering a penalty for terminating
                                                    the original policy. </i>
                                            </p>
                                        </div>
                                    </div>
                                    <div class="bottom"></div>
                                </div>
                                
                                <div class="seperator"></div>

                                <script type="text/javascript">
                                IncreaseProgress(70);
                                </script>
                                
                                <div class="hilite" style="display: " id="divPaymentModeHeader">
                                    <div class="top"></div>
                                    <div class="body_in pad_15x" id="divPaymentMode">
                                        <h1>Payment Mode</h1>
                                        <div class="seperator"></div>
                                        I / We authorised <b>HSBC Insurance Pte. Limited</b> to debit the premium amount due in connection with above insurance policy.
                                        <div class="seperator"></div>
                                        <div>
                                            <div id="divNameoftheCard">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Cardholder's Name:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtNameoftheCard" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvNameoftheCard" ControlToValidate="txtNameoftheCard"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divIssuingBank">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Issuing Bank:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtIssuingBank" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvIssuingBank" ControlToValidate="txtIssuingBank"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divCardNo">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Credit Card Number:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtCardNo1" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo2" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo3" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo4" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo1" ControlToValidate="txtCardNo1" ErrorMessage=""
                                                        ValidationGroup="proposal" CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo1" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{4}" ControlToValidate="txtCardNo1"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo2" ControlToValidate="txtCardNo2" ErrorMessage=""
                                                        ValidationGroup="proposal" CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo2" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{4}" ControlToValidate="txtCardNo2"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo3" ControlToValidate="txtCardNo3" ErrorMessage=""
                                                        ValidationGroup="proposal" CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo3" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{4}" ControlToValidate="txtCardNo3"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo4" ControlToValidate="txtCardNo4" ErrorMessage=""
                                                        ValidationGroup="proposal" CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo4" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{4}" ControlToValidate="txtCardNo4"></asp:RegularExpressionValidator>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtCreditCardValid"
                                                        ValidationGroup="proposal" ID="csvCreditCardValid" runat="server" ErrorMessage="Credit Card number not valid."
                                                        Text="" OnServerValidate="csvCreditCardValid_ServerValidate"></asp:CustomValidator>
                                                    <span style="display: none">
                                                        <asp:TextBox ID="txtCreditCardValid" Text="Valid" runat="server"></asp:TextBox>
                                                    </span>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divCardExpiry">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Card Expiry Date:</div>
                                                <div class="left">
                                                    <asp:DropDownList ID="ddlCardExpiryMonth" runat="server">
                                                        <asp:ListItem Selected="True" Value="-1">mm</asp:ListItem>
                                                        <asp:ListItem Value="01">01</asp:ListItem>
                                                        <asp:ListItem Value="02">02</asp:ListItem>
                                                        <asp:ListItem Value="03">03</asp:ListItem>
                                                        <asp:ListItem Value="04">04</asp:ListItem>
                                                        <asp:ListItem Value="05">05</asp:ListItem>
                                                        <asp:ListItem Value="06">06</asp:ListItem>
                                                        <asp:ListItem Value="07">07</asp:ListItem>
                                                        <asp:ListItem Value="08">08</asp:ListItem>
                                                        <asp:ListItem Value="09">09</asp:ListItem>
                                                        <asp:ListItem Value="10">10</asp:ListItem>
                                                        <asp:ListItem Value="11">11</asp:ListItem>
                                                        <asp:ListItem Value="12">12</asp:ListItem>
                                                    </asp:DropDownList>
                                                    <asp:DropDownList ID="ddlCardExpiryYear" runat="server">
                                                    </asp:DropDownList>
                                                    <asp:RequiredFieldValidator ID="rfvCardExpiryMonth" ControlToValidate="ddlCardExpiryMonth"
                                                        ErrorMessage="" ValidationGroup="proposal" InitialValue="-1" Text="" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardExpiryYear" ControlToValidate="ddlCardExpiryYear"
                                                        ErrorMessage="" ValidationGroup="proposal" InitialValue="-1" Text="" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtCCExpiredValid"
                                                        ValidationGroup="proposal" ID="csvCCExpiredValid" runat="server" ErrorMessage="Credit Card expire not valid."
                                                        Text="" OnServerValidate="csvCCExpiredValid_ServerValidate"></asp:CustomValidator>
                                                    <span style="display: none">
                                                        <asp:TextBox ID="txtCCExpiredValid" Text="Valid" runat="server"></asp:TextBox>
                                                    </span>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divCardType">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Card Type:</div>
                                                <div class="left">
                                                    <span id="divVisa">
                                                        <asp:RadioButton onclick="ValCheckCardType();CheckCardTypeValidationCss();" ID="rdoVisa"
                                                            runat="server" GroupName="cardtype" />&nbsp;
                                                        <asp:Label ID="lblVisa" class="pad_10xr" runat="server" Text="VISA"></asp:Label>
                                                    </span>
                                                    <span id="divMasterCard">
                                                        <asp:RadioButton onclick="ValCheckCardType();CheckCardTypeValidationCss();" ID="rdoMasterCard"
                                                            runat="server" GroupName="cardtype" />&nbsp;
                                                        <asp:Label ID="lblMasterCard" runat="server" Text="MasterCard"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtCardType" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvCardType" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtCardType" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                    <div class="clear"></div>
                                                    <em class="note">(Only VISA or Master Credit Card is acceptable for premium payment)</em>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="seperator"></div>
                                        By submitting this proposal form, I am aware that any refund will be paid by cheque
                                        the Insured/Policyholder. <b>HSBC Insurance Pte. Limited</b> will consider all declared
                                        information as true and correct. This Credit Card payment is subject to the terms
                                        of the Credit Card Agreement.
                                    </div>
                                    <div class="bottom"></div>
                                </div>
                    
                                <script type="text/javascript">
                                    IncreaseProgress(85);
                                </script>
                                
                                <div class="seperator"></div>
                                
                                <div class="center align_center" id="divFormButtons">
                                    <asp:ImageButton ID="ibtSubmit" OnClientClick="LoadValidationErrorCss();CheckOptionValidationCss();"
                                        runat="server" ValidationGroup="proposal" ImageUrl="~/images/forms_proposal/button/submit.png"
                                        class="button" OnClick="ibtSubmit_Click" />
                                    <asp:Label ID="lblMessage" runat="server" ForeColor="Red"></asp:Label>
                                    <div class="note">
                                        <img src="/images/forms_proposal/icon/warning.png" width="21" height="18" alt="Note"
                                            style="vertical-align: middle; padding-bottom: 3px" />
                                        <strong>Note</strong>, by clicking on the SUBMIT button you agree to our Website's
                                        <a href="../../terms/terms.aspx" target="_blank">Terms &amp; Conditions</a>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="bottom"></div>
                    </div>
                </div>
                <div class="seperator"></div>
            </div>
        </div>
    </div>
    
    <div id="footer">
        <div id="nav_bottom" class="pad_7t">
            <div class="left pad_8yr">
                <a href="/personal-accident/results.aspx" onclick="return confirm('Are you sure to go back?');">
                    <img src="/images/forms_proposal/button/back.png" alt="Back" /></a>
            </div>
            <div class="right pad_8yr">
                <a href="#" onClick="window.print()"><img src="/images/forms_proposal/button/print.png" alt="Print" /></a>
            </div>
        </div>
    </div>
    <script type="text/javascript">

        function ShowHideDiv(divName, varOnOff) {
            if (varOnOff) {
                document.getElementById(divName).style.display = "";
            }
            else {
                document.getElementById(divName).style.display = "none";
            }
        }

        //        function ShowHideSpouseStatus() {
        //            var policytype = document.getElementById('<%=txtPolicyType.ClientID%>').value;
        //            if (policytype == 'Individual') {
        //                ShowHideDiv('divDetailsOfOtherInsured', false);
        //                ValSpouse(false);
        //            }
        //            else if (policytype == 'Individual & Spouse') {
        //                ShowHideDiv('divDetailsOfOtherInsured', true);
        //                ValSpouse(true);
        //            }
        //            else if (policytype == 'Individual & Children') {
        //                ShowHideDiv('divDetailsOfOtherInsured', false);
        //                ValSpouse(false);
        //            }
        //            else {
        //                ShowHideDiv('divDetailsOfOtherInsured', true);
        //                ValSpouse(true);
        //            }
        //        }

        //        function ValSpouse(varOnOff) {
        //            ValidatorEnable(document.getElementById('<=rfvSpouseName.ClientID>'), varOnOff);
        //            ValidatorEnable(document.getElementById('<=revSpouseName.ClientID>'), varOnOff);
        //            ValidatorEnable(document.getElementById('<=ddlSpouseIdNumber.ClientID>' + "_csvIdPrefix"), varOnOff);
        //            ValidatorEnable(document.getElementById('<=ddlSpouseIdNumber.ClientID>' + "_rfvIdNumber"), varOnOff);
        //            ValidatorEnable(document.getElementById('<=ddlSpouseIdNumber.ClientID>' + "_revIdNumberLength"), varOnOff);
        //            ValidatorEnable(document.getElementById('<=ddlSpouseIdNumber.ClientID>' + "_csvIdNumber"), varOnOff);
        //            ValidatorEnable(document.getElementById('<=ddlSpouseIdNumber.ClientID>' + "_csvIdPostfix"), varOnOff);
        //            ValidatorEnable(document.getElementById('<=ddlSpouseNationality.ClientID>' + "_rfvNationality"), varOnOff);
        //        }

        function CheckSPRPR() {
            var ctrlTxt = document.getElementById('<%=txtSPRPR.ClientID%>');
            var ctrlY = document.getElementById('<%=chkSPRPR.ClientID%>');
            var valCtrl = document.getElementById('<%=rfvSPRPR.ClientID%>');
            if (ctrlY.checked == true) {
                ctrlTxt.value = '1';
                valCtrl.style.visibility = 'hidden';
            }
            else {
                ctrlTxt.value = '';
            }
        }

        function CheckElgibleAge() {
            var ctrlTxt = document.getElementById('<%=txtElgibleAge.ClientID%>');
            var ctrlY = document.getElementById('<%=chkElgibleAge.ClientID%>');
            var valCtrl = document.getElementById('<%=rfvElgibleAge.ClientID%>');
            if (ctrlY.checked == true) {
                ctrlTxt.value = '1';
                valCtrl.style.visibility = 'hidden';
            }
            else {
                ctrlTxt.value = '';
            }
        }

        function CheckOptionValidationCss() {
            CheckEngagedValidationCss();
            CheckCardTypeValidationCss();
            //ShowHideSpouseStatus();
        }

        function CheckValidationCss(divYes, divNo, ctrlText, valCtrl) {
            ShowValidationEffectOption(divYes, divNo, ctrlText, valCtrl);
            return true;
        }

        //alert("0");
        function CheckEngagedValidationCss() {
            CheckValidationCss('divNoEngaged', 'divYesEngaged', '<%=txtEngaged.ClientID%>', '<%=rfvEngaged.ClientID%>');
        }
        //alert("1");
        //        function ValEngaged1() {
        //            var txtCtrl = document.getElementById("<=txtEngaged.ClientID>");
        //            txtCtrl.value = "1";
        //        }

        function ValEngaged() {
            var txtCtrl = document.getElementById('<%=txtEngaged.ClientID%>');
            var ctrlY = document.getElementById('<%=rdoYesEngaged.ClientID%>');
            var ctrlN = document.getElementById('<%=rdoNoEngaged.ClientID%>');
            var valSameAddress = document.getElementById('<%=rfvEngaged.ClientID%>');
            if (ctrlY.checked == true || ctrlN.checked == true) {
                txtCtrl.value = '1';
                txtCtrl.style.visibility = 'hidden';
            }
            else {
                txtCtrl.value = '';
            }
        }
        //alert("2");
        function CheckCardTypeValidationCss() {
            CheckValidationCss('divVisa', 'divMasterCard', '<%=txtCardType.ClientID%>', '<%=rfvCardType.ClientID%>');
        }

        function ValCheckCardType(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtCardType.ClientID%>");
            txtCtrl.value = "1";
        }


        function CheckSalGenderValid(source, arguments) {
            var ctrlsal = document.getElementById('<%=ddlSalutation.ClientID%>' + '_ddlSal');
            var ctrlgender = document.getElementById('<%=ddlGender.ClientID%>' + '_ddlGender');

            var sal = ctrlsal.value;
            var gender = ctrlgender.value;
            var result = true;
            if (gender == 'M') {
                if (sal == 'Ms' || sal == 'Miss' || sal == 'Mdm' || sal == 'Mrs') {
                    result = false;
                }
            }
            else if (gender == 'F') {
                if (sal == 'Mr') {
                    result = false;
                }
            }

            if (result == false) {
                ctrlsal.style.backgroundColor = '#fcc';
                ctrlsal.style.border = 'Solid 1px #f00';

                ctrlgender.style.backgroundColor = '#fcc';
                ctrlgender.style.border = 'Solid 1px #f00';
            }
            else {
                ctrlsal.style.backgroundColor = '';
                ctrlsal.style.border = '';

                ctrlgender.style.backgroundColor = '';
                ctrlgender.style.border = '';
            }
            arguments.IsValid = result;
        }

        var hookAVal = false;
        function HookSalValidation() {
            if (hookAVal == false) {
                prefix = "<%=ddlSalutation.ClientID%>";
                var ddlSal = prefix + "_ddlSal";
                prefix = "<%=ddlGender.ClientID%>";
                var ddlGender = prefix + "_ddlGender";
                var valCtrl = "<%=csvSalGender.ClientID%>";
                ValidatorHookupControlID(ddlSal, document.getElementById(valCtrl));
                ValidatorHookupControlID(ddlGender, document.getElementById(valCtrl));
                hookAVal = true;
            }
        }

        function Check2NRICValid(source, arguments) {
            var ddlnricpref = document.getElementById('<%=ddlIdNumber.ClientID%>' + '_ddlIdPrefix');
            var txtnricnum = document.getElementById('<%=ddlIdNumber.ClientID%>' + '_txtIdNumber');
            var ddlnricsuffix = document.getElementById('<%=ddlIdNumber.ClientID%>' + '_ddlIdPostfix');
            var applicantNRIC = ddlnricpref.value + txtnricnum.value + ddlnricsuffix.value;

            var ddlspousenricpref = document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + '_ddlIdPrefix');
            var txtspousenricnum = document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + '_txtIdNumber');
            var ddlspousenricsuffix = document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + '_ddlIdPostfix');
            var spouseNRIC = ddlspousenricpref.value + txtspousenricnum.value + ddlspousenricsuffix.value;

            var result = true;


            if (applicantNRIC == spouseNRIC) {
                result = false;
            }
            else {
                result = true;
            }

            if (result == false) {
                ddlnricpref.style.backgroundColor = '#fcc';
                ddlnricpref.style.border = 'Solid 1px #f00';
                txtnricnum.style.backgroundColor = '#fcc';
                txtnricnum.style.border = 'Solid 1px #f00';
                ddlnricsuffix.style.backgroundColor = '#fcc';
                ddlnricsuffix.style.border = 'Solid 1px #f00';

                ddlspousenricpref.style.backgroundColor = '#fcc';
                ddlspousenricpref.style.border = 'Solid 1px #f00';
                txtspousenricnum.style.backgroundColor = '#fcc';
                txtspousenricnum.style.border = 'Solid 1px #f00';
                ddlspousenricsuffix.style.backgroundColor = '#fcc';
                ddlspousenricsuffix.style.border = 'Solid 1px #f00';
            }
            else {
                ddlnricpref.style.backgroundColor = '';
                ddlnricpref.style.border = '';
                txtnricnum.style.backgroundColor = '';
                txtnricnum.style.border = '';
                ddlnricsuffix.style.backgroundColor = '';
                ddlnricsuffix.style.border = '';

                ddlspousenricpref.style.backgroundColor = '';
                ddlspousenricpref.style.border = '';
                txtspousenricnum.style.backgroundColor = '';
                txtspousenricnum.style.border = '';
                ddlspousenricsuffix.style.backgroundColor = '';
                ddlspousenricsuffix.style.border = '';
            }
            arguments.IsValid = result;
        }

        var hookCompareVal = false;
        function HookCompareICValidation() {
//            if (hookCompareVal == false) {
//                prefix = "<%=ddlIdNumber.ClientID%>";
//                var ddlnricpref = prefix + "_ddlIdPrefix";
//                var txtnricnum = prefix + "_txtIdNumber";
//                var ddlnricsuffix = prefix + "_ddlIdPostfix";

//                prefix = "<%=ddlSpouseIdNumber.ClientID%>";
//                var ddlspousenricpref = prefix + "_ddlIdPrefix";
//                var txtspousenricnum = prefix + "_txtIdNumber";
//                var ddlspousenricsuffix = prefix + "_ddlIdPostfix";
//                var valCtrl = "<=csvNRIC.ClientID>";

//                ValidatorHookupControlID(ddlnricpref, document.getElementById(valCtrl));
//                ValidatorHookupControlID(txtnricnum, document.getElementById(valCtrl));
//                ValidatorHookupControlID(ddlnricsuffix, document.getElementById(valCtrl));
//                ValidatorHookupControlID(ddlspousenricpref, document.getElementById(valCtrl));
//                ValidatorHookupControlID(txtspousenricnum, document.getElementById(valCtrl));
//                ValidatorHookupControlID(ddlspousenricsuffix, document.getElementById(valCtrl));
                 hookCompareVal = true;
//            }
        }

        function showhide(el) {

            el = document.getElementById(el);
            el.style.display = (el.style.display == "none") ? "block" : "none";

        }

        window.onload = function() {
            //alert("1");
            //showhide('divDetailsOfOtherInsured');
            //showhide('divDeclaration');
            //showhide('divAuthorisation');
            //showhide('divPaymentMode');
            //showhide('divImNotice');
            //ShowHideSpouseStatus();
            //alert("2");
            if (document.getElementById('<%=rdoNoEngaged.ClientID%>').checked == true) {
                ValEngaged();
                //alert("3");
            }

            else if (document.getElementById('<%=rdoYesEngaged.ClientID%>').checked == true) {
                ValEngaged();
            }
            else { ValEngaged(); }
            //alert("4");
            if (document.getElementById('<%=txtCardType.ClientID%>').value == "1") {
                ShowHideDiv('divPaymentMode', true);
            }
            else { ShowHideDiv('divPaymentMode', true); }
            //alert("5");
        }

        function restrictToNumbers(e) {
            if ([e.keyCode || e.which] == 8 || [e.keyCode || e.which] == 37 || [e.keyCode || e.which] == 9 || [e.keyCode || e.which] == 39) //this is to allow backspace
                return true;

            if ([e.keyCode || e.which] < 48 || [e.keyCode || e.which] > 57)
                e.preventDefault ? e.preventDefault() : e.returnValue = false;
        }

        function requestByPostCode() {
            try {
                var _pcode = document.getElementById('<%=txtPostCode.ClientID%>').value;
                if (_pcode.length != 6) {
                    alert('Postal code length must be 6 numbers value.');
                    document.getElementById('<%=txtAddress.ClientID%>').value = '';
                    return false;
                }
                else {
                    requestData(_pcode);
                }
            }
            catch (e) {
                alert(e.toString());
            }
        }


        function set_data(json) {
            try {
                var srcTable = $("#divAddress").empty();
                var txtAddress = document.getElementById('<%=txtAddress.ClientID%>');
                if (json == null) {
                    $("<table><tr><td>No address found!</td></tr></table>").appendTo(srcTable);
                    alert("No address found!");
                    document.getElementById('<%=txtPostCode.ClientID%>').value = "";
                    txtAddress.value = "No Address found.";
                    return;
                }
                if (json.length == 0) {
                    $("<table><tr><td>No address found!</td></tr></table>").appendTo(srcTable);
                    alert("No address found!");
                    document.getElementById('<%=txtPostCode.ClientID%>').value = "";
                    txtAddress.value = "No Address found.";
                    return;
                }

                var tbl = $("<table width='50%'>");

                var tbody = $("<tbody>");
                var no = 1;
                for (var i = 0; i < json.length; i++) {
                    var trow = $("<tr>"), rec = json[i];
                    if (rec.t != null) {

                        var ctn = rec.t + "<br>" + rec.a;

                        //$("<td>").text(no).data("col", 1).appendTo(trow);
                        $("<td>").html(ctn).data("col", 2).appendTo(trow);
                        if (i == 0) {
                            txtAddress.value = rec.t + "\n" + rec.a;
                        }
                        else {
                            txtAddress.value += "\n\n" + rec.t + "\n" + rec.a;
                        }
                        no++;
                    }
                    trow.appendTo(tbody);
                }
                tbody.appendTo(tbl);
                //alert(srcTable);
                tbl.appendTo(srcTable);
            }
            catch (e) {
                alert(e.toString());
            }
        }

        function PostCodeChange() {
            document.getElementById('divAddress').innerHTML = "Your postcode changed.";
            document.getElementById('divAddress').style.display = 'none';
            document.getElementById('<%=txtAddress.ClientID%>').innerHTML = "Your postcode changed.\nGetting address from street directory...";
        }
    </script>

    <script type="text/javascript">
        IncreaseProgress(100);
        HideLoading();
    </script>
    <script src="../../includes/personalaccident/hsbc.proposalform.js" type="text/javascript"></script>
</asp:Content>
